Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 6, pp 819–825 | Cite as

Mid-term outcome of arthroscopic AMIC for the treatment of articular cartilage defects in the knee joint is equivalent to mini-open procedures

  • J. Schagemann
  • P. Behrens
  • A. Paech
  • H. Riepenhof
  • B. Kienast
  • H. Mittelstädt
  • J. Gille
Arthroscopy and Sports Medicine



We present the first retrospective study that compares two various autologous matrix-induced chondrogenesis (AMIC) surgical interventions to repair grade III–IV cartilage defects in the knee. Patients who underwent minimally invasive (arthroscopy) or open (mini-arthrotomy) AMIC were followed up to 2 years to investigate if minimally invasive AMIC is superior to open procedures.

Materials and methods

Overall n = 50 patients with focal and contained grade III–IV articular cartilage defects in the knee joint were followed in a consecutive cohort study. 20 patients were treated arthroscopically (female 7, male 13; age: mean 38.2 years, range 18–70 years; BMI: mean 27.0, range 18.7–34.7; defect size: mean 3.1 cm2, range 1.0–6.0 cm2), and 30 patients via mini-arthrotomy (female 13, male 17; age: mean 34.4 years, range 14–53 years, BMI: mean 23.9, range 18.4–28.7; defect size: mean 3.4 cm2, range 1.5–12.0 cm2). The primary defect localization was the medial femoral condyle.


AMIC led to a significant improvement of VAS pain, KOOS and Lysholm scoring for up to 2 years compared to pre-op. Outcome analysis revealed no significant differences between the two different surgical approaches.


Our results suggest that mini-open AMIC is equivalent to the arthroscopic procedure. The anticipatory hypothesis that minimally invasive approaches bring greater patient benefit per se could not be confirmed. Therefore, we recommend to perform AMIC where indicated and suggest that the surgeon’s personal skills profile guide the choice of surgical approach.

Level of evidence



AMIC Arthroscopy Mini open Cartilage repair Minimally invasive 



No external funding was received.

Compliance with ethical standards

Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and publication of this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the institutional ethical committee (98/056).

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • J. Schagemann
    • 1
  • P. Behrens
    • 2
  • A. Paech
    • 1
  • H. Riepenhof
    • 3
  • B. Kienast
    • 3
  • H. Mittelstädt
    • 1
  • J. Gille
    • 1
    • 3
  1. 1.Clinic for Orthopedics and Trauma SurgeryUniversity Medical Center Schleswig HolsteinLuebeckGermany
  2. 2.CUNO, Praxis Tonndorfer HauptstraßeHamburgGermany
  3. 3.BG Klinikum HamburgHamburgGermany

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